Updates on news and views from the Morgan County Citizen in Madison, Georgia.

Friday, September 11, 2009

More health care fact and fiction

In this week's paper, we shed a little light on some common claims about health care (if you missed it, you can catch up here), so now we're back to deconstruct a few more assertions flying around in the debate over HR 3200.

We picked which issues to address here based on what U.S. Rep. Paul Broun said in his visit last week and which ones came up most often in our searches of online forums, other news outlets, chain e-mails, statements from prominent politicians and advocacy sites.

We fact-checked everything against the House version of the legislation itself, and then against transcripts of speeches, interviews and public statements given by the President, other relevant politicians and federal offices like the Congressional Budget Office and the White House.

This just hits the highlights, but if you'd like to see a specific issue addressed, just e-mail us.

Now that we've dispensed with the disclaimers, read on for the real information.

Half True: This is really a commentary on the swirling debate over rationing. Many have claimed that a provision in the bill for a "comparative effectiveness research center" means that the government will deny life-saving care to sick people because they aren't worth enough.

The research in question will be studies of which medicines and treatments work best and which are most cost-effective. Some have hypothesized that the findings will be used to drastically ration care, but that is not only false, the House bill itself would make it illegal. After describing the research body and its functions, governance, etc., it goes on to say that that "nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer.’’.

However, it would be unfair to say that there will be no rationing under the new plan - there will be. But keep in mind, there's rationing now under private care. No insurer will let you see any doctor you want at any time. The question, really, is whether rationing under HR 3200 would be more or less drastic, and that is a valid point for debate

People 65 and over must go to counseling every year to talk "about how to die."

Not True: Section 1233 of the House version stipulates that Medicare must pay for consultations every five years (or more, if the person's health situation changes) with a health care professional to talk about "Advance Care Planning."

Some of the things that includes are power of attorney, living wills, advance directives and health care proxies, as well as resources for the individual to use like local attorneys, etc.

What it does not mention is how to decrease nutrition, how to commit suicide or the dollar-amount someone's life is worth. It is also important to note that these sessions are voluntary, although some argue that they are not entirely so.

A doctor may also initiate the sessions, and they've got financial incentive to do so. While the patient can refuse, the opinion of a doctor can be intimidating and seem authoritative, so some may not. Therefore, it would be fair to say that they are not entirely by patient choice alone, but they are certainly not mandatory.

This bill would mean big tax increases.

Half True: Section 441 imposes a surcharge - a friendly word for tax increase - on "high-income individuals". But just how high is high-income?

For those earning between $350,000 and $500,000, they get an extra 1 percent. The $500,000 to $1 million set will owe an additional 1.5 percent. If you make $1 million or more, you'll be paying 5.4 percent on your modified adjusted gross income.

For the rest of us, this bill doesn't include a tax hike (unless you choose not to have medical insurance, in which case you're looking at a 2.5 percent uptick).

This plan puts an end to giant out-of-pocket expenses like deductibles and co-pays.

Half True: It depends on what you consider 'giant.'

Section 122 puts caps on how high out-of-pocket costs can go - $5,000 a year for individuals, $10,000 for a family - for the first year of the plan. From then on, the figure will go up yearly at the same rate as the consumer pricing index (inflation).

However, employer provided plans have five years to jump on the band-wagon, so if you keep the insurance your employer provides, expect the same out-of-pocket limits as always for the first five years.

This reform plan is going to create immediate change.

Not True: While the changes laid out in this plan are ambitious and would change the face of American health care financing, it will not happen overnight.

Many on the democratic side of the debate - especially grassroots movements like MoveOn.org - are stressing the need for reform because more time means more of the uninsured getting ill, dying or going bankrupt.

While this is true, the major paradigm shifts proposed in HR 3200 will be phased in, most of them not coming into full effect until 2013. Every time the legislation says "year one" or talks about something happening in the first year, that year is 2013.

This means that the health insurance exchange, the public option, regulations on caps and expenses and most of the other major provisions will start then.

The majority of Americans want a public option.

Half True: The danger with statistics is that you can always find one to back you up, and health care is no different.

There are a wealth of polls that offer public opinions on health care reform and its various components. But it's important to consider the questions asked, as well as the time of the polls.

A late-July poll by Time magazine showed 46 percent of respondents think it's "very important" that health care reform be passed in the next few months. 56 percent of those polled said they supported a public option, 47 percent trust Obama with health care reform and 37 percent trust Republicans in Congress.

From other polls, there's an oft-cited statistic floating around the blogosphere and traveling the e-mail circuit that claims 76 percent of Americans want a public option. That number comes from a mid-June NBC News/Wall Street Journal poll that found 41 percent thought having a public option was "extremely important" and 35 percent rated it "quite important." Take 41, throw in 35 and, bang! You have 76.

However, another more recent poll by the Kaiser Family Foundation found only 59 percent in favor of a public option. Another NBC/Wall Street Journal poll run in mid-August found 43 percent favor the public option, 47 percent oppose it.

While some of these do constitute a majority, none are overwhelmingly so, and the numbers change as the debate wears on. Results are different with each poll, and many show Americans tentatively in favor of a public option, but it isn't entirely accurate to say that most Americans want it.

For more information on these and other questions on the House health care bill, please see the bill itself, which can be found here.

If you're interested to see what President Obama has to say about many of these issues, we recommend this transcript of an informative interview with conservative radio talk show host Michael Smerconish last month.

1 comment:

What you liberals do not seem to understand is that our oposition to Obama's healthcare plan is about FREEDOM.What all of Obama's plans have been about, whether it's college loans or the auto industry, is CONTROL.This is why 2,000,000 marched in Washington DC. They were marching for FREEDOM